London Medical Cardiology

Renal Artery Stenosis 

London Medical’s Cardiology Clinic provides the most up-to-date investigative cardiac procedures for patients with heart problems – and some of the UK’s most renowned cardiologists hold clinics here for all aspects of heart disease.

Renal artery stenosis is a condition where your kidney artery blood supply becomes blocked or narrowed. Left untreated, it can cause hypertension (high blood pressure) and eventually lead to kidney failure. 

Here at London Medical, our team of specialists can diagnose and treat renal artery stenosis to prevent further complications. 

If you are concerned about any particular symptom of renal artery stenosis, we can offer you peace of mind and an effective treatment plan to target the cause of your condition.

Causes of renal artery stenosis

There are two leading causes of renal artery stenosis — atherosclerosis and fibromuscular dysplasia. 

Atherosclerosis occurs when fat, cholesterol and plaque build up in your renal artery. Over time, this build-up can start to harden and reduce blood flow through the artery, causing it to gradually narrow in a process known as stenosis. 

Fibromuscular dysplasia occurs when the muscle of your renal artery wall does not grow properly. This can result in the renal artery having narrow and wide sections, causing blood flow to the kidney to be restricted. 

Renal artery stenosis can also be caused as a result of inflamed blood vessels or growths in your abdomen. However, this happens a lot more rarely. 

Renal artery stenosis symptoms

Renal artery stenosis does not usually cause any noticeable symptoms until it becomes more advanced. In fact, it may only be discovered accidentally when testing for different conditions, like hypertension. 

When renal artery stenosis becomes advanced, symptoms can include: 

  • High blood pressure that is difficult to manage 
  • Swelling in your body’s tissues
  • Heart failure that is resistant to treatment 
  • High protein levels in your urine 
  • Worsening kidney function 

These symptoms might not be noticeable to you and may only be detected when your doctor checks your health. However, if you do notice any of these symptoms, make sure to consult a healthcare professional as soon as possible. 

Renal artery stenosis complications

If left untreated, renal artery stenosis can go on to cause many possible complications. These can include: 

  • Hypertension
  • Kidney failure that requires dialysis or a kidney transplant (usually only if both kidneys are involved) 
  • Fluid retention, especially in your feet and ankles 
  • Shortness of breath caused by fluid buildup in your lungs (flash lung oedema)

Diagnosing renal artery stenosis

At London Medical, our team can diagnose renal artery stenosis in a variety of ways. 

While we will typically diagnose the condition using an imaging test, we will generally review your medical history and perform a physical examination beforehand. 

During clinical examination, a stethoscope will be used to listen to possible murmurs coming from the narrowed artery of your kidneys that could suggest your artery has narrowed. Following this, blood and urine tests may be used to assess your kidney function and hormone levels that regulate your blood pressure. 

To make an accurate diagnosis, certain imaging tests will then be used. These may include: 

  • Magnetic resonance angiography (MRA) — uses strong magnetic fields to create 3D images of your renal arteries and kidneys. A dye injection then allows your arteries and blood vessels to be seen on the images. 
  • Computed tomography (CT) scan — uses an X-ray machine to create detailed images of your renal arteries and also involves contrast injections. 
  • Doppler ultrasound — uses high-frequency sound waves to produce images of your arteries and kidneys. Using Doppler technique also shows the function of them both, as well as any blockages in your blood vessels. 
  • Renal arteriography — requires insertion of catheters through the groin into your renal arteries, a specific type of X-ray and contrast injection to show blockages. Through the inserted catheters, a narrowed artery can be opened with a balloon and/or stent.

Treating renal artery stenosis

Treatment for renal artery stenosis involves multiple different facets of treatment (for example, blood pressure lowering medication or ballooning and stenting of the narrowed artery) to help manage your condition and treat it. 

Lifestyle changes 

If your blood pressure is elevated due to renal artery stenosis, making certain lifestyle changes like limiting your salt intake, exercising regularly and eating a healthy, well-balanced diet can help you manage it more easily. However, this will not be enough to treat high blood pressure or renal artery stenosis on its own. 

Medication 

Angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) are common medications used to treat renal artery stenosis and need to be used carefully. These work by blocking the production of angiotensin II – a hormone that is elevated in this condition 

and causes blood vessels to narrow and blood pressure to increase – and slowing the progression of kidney disease. 

As well as ACE and ARBs, you may be prescribed a diuretic (a medication that supports your kidneys when removing fluids from your blood). This will then help your body expel any excess water and sodium. 

Beta-blockers and alpha-beta-blockers may also be recommended but only as a second choice. These slow down your heartbeat and make your heart beat less forcefully, stopping your arteries from widening and potentially worsening the effects of renal artery stenosis. 

Medical procedures

If medication is not improving your kidney function, surgical treatment may be required. Some of the main medical procedures used to treat renal artery stenosis typically include: 

  • Renal angioplasty and stenting — this treatment involves widening the narrowed renal artery by using a balloon and/or a stent. Once placed inside your blood vessel, this then holds the walls open to enhance blood flow. 
  • Renal artery bypass surgery — this treatment involves grafting a new blood vessel into your renal artery to provide your blood with a new route to reach your kidneys. This can sometimes mean your renal artery needs to be connected to your liver or spleen and is usually only recommended if an angioplasty is unsuccessful. Today, this is very rarely performed.

Get checked at London Medical 

Since renal artery stenosis doesn’t have any noticeable symptoms, regular health check-ups are vital. After all, the earlier the condition can be caught, the easier it will be to treat and manage. 

Here at London Medical, we take a combined approach to treatment and can help you find the right solutions for your health. 

If you are diagnosed with renal artery stenosis, we will create a personalised treatment plan for you that supports your daily health and safeguards your future. 

Contact our team for further support on how to treat and manage renal artery stenosis.

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